[Surgical experience of idiopathic peripheral pulmonary arterial aneurysm; report of a case].

Peripheral pulmonary arterial aneurysm has rarely been reported, and although most cases show symptoms of hemoptysis. We experienced a case of idiopathic peripheral pulmonary arterial aneurysm in the asymptomatic period noted on medical examination. The patient was a 49-year-old man with coin lesion which was 15 mm in diameter in the right lower lung field on chest X-ray film at the 1st visit. It was strongly stained on enhanced computed tomography in the right S4 and continuity with the pulmonary arteries was suggested. The right middle lobectomy was performed under the diagnosis of peripheral pulmonary arterial aneurysm. Histological examination of the resected specimen revealed that the prominent thinning in the arterial wall, however, there was no evidence of specific chronic inflammation. The postoperative course was good. The patient has been well without new pulmonary arterial aneurysm for 2 years after the surgery.

Evaluation of NT-pro BNP and CT-ANP as markers of concentric hypertrophy in dogs with a model of compensated aortic stenosis.

BACKGROUND: Serum C-terminal atrial natriuretic peptide (CT-ANP) and N-terminal pro B-type natriuretic peptide (NT-pro BNP) concentrations have not been measured serially in dogs with chronic pressure overload of the heart. HYPOTHESIS: We investigated whether serial evaluation of CT-ANP and NT-pro BNP concentrations is a useful guide to the risk of cardiac remodeling in dogs with a model of aortic stenosis. ANIMALS: Six male Beagles. METHODS: After anesthesia, the aorta was constricted with a polyester band and mean left ventricular systolic pressure (LVPs) was 50 mmHg above baseline. Echocardiographic and intracardiac catheter examinations and blood sampling were performed before surgery and 3 and 6 months after surgery. RESULTS: LVP and left ventricular end-diastolic pressure (LVEDP) were significantly higher at 6 months. Compared with baseline, end-diastolic intraventricular septum thickness (IVSd), left ventricular posterior wall thickness (LVPWd), and relative wall thickness (RWT) were significantly increased 3 and 6 months after aortic constriction. Serum CT-ANP concentrations were increased significantly at 3 months and serum NT-pro BNP concentrations were significantly higher 3 and 6 months after aortic constriction. Serum NT-pro BNP concentration was significantly correlated with LVEDP and IVSd whereas serum CT-ANP concentration was not correlated with any measurement. Stepwise regression analysis showed that LVEDP, IVSd, and RWT could predict serum NT-pro BNP. CONCLUSIONS AND CLINICAL IMPORTANCE: This study indicated the differential regulation of NT-pro BNP and CT-ANP concentrations during pressure overload. NT-pro BNP assay may be used as an additional screening method to stratify early-stage ventricular remodeling because of aortic constriction.

Bilateral giant myelolipoma in the adrenal of a cotton-top tamarin (Saguinus oedipus).

A rare case of bilateral adrenal myelolipomas in a female cotton-top tamarin is reported. Large bilateral masses in the adrenal glands were composed of mature adipose cells containing varying amounts of hematopoietic cells of the myeloid, erythroid, and megakaryocytic series. The gross and histologic features of this case closely resemble human "giant" adrenal myelolipomas.

Adenocarcinoma in the rectum of a capped langur (Presbytis pileata).

A rectal adenocarcinoma in a 22-year-old capped langur histologically resembling those in human cases is reported. An ill-defined diffuse tumor with fibrously firm rectal wall showed diffuse infiltrative growth of signet-ring cancer cells. Immunohistochemistry demonstrated positive staining for CEA, lysozyme, EMA, keratin and B72.3.

[A case of intrapleural rupture of pulmonary arteriovenous malformation with shock].

We report a case of a 59-year-old male who suddenly developed massive right hemothorax and shock due to pulmonary arteriovenous malformation (AVM). He was admitted as an emergency case because of severe back pain, cyanosis and cold sweat. Although shock with massive right hemothorax was found, echocardiographic and X-ray computed tomographic examination showed no dilatation of the aorta, no intimal flap in the aorta and no pericardial effusion which suggested aneurysm. Pulmonary arteriography, performed subsequently, disclosed intrapleural rupture of the right pulmonary AVM. The patient recovered successfully from the state of shock. The pulmonary AVM was removed by segmentectomy of the right lung (S4). He was discharged following an uneventful postoperative course. Intrapleural rupture with shock is a very rare complication of pulmonary AVM. Pulmonary AVM should be considered as one possible cause in patients with massive hemothorax and shock.